On the Whanau Ora scheme

April 9th, 2010

At the unveiling of Whanau Ora, the government scrapped a key feature that its expert Task Force had deemed to be ‘pivotal’ – namely, that this new system of social service delivery should be run by an independent trust. Instead, it will be run from within the current government system, by a body comprised of three CEOs of Health, Social Welfare and te Puna Kokiri – and three members of the Task Force. Presumably, the same objective remains: “Of ensuring Whanau Ora is implemented across the full range of government activity.” We shall see.

Hopefully, keeping governance within the state system will improve the accountability of Whanau Ora and minimize the chances of these kind of headlines while still leaving the basic goal of universal application intact. Some people would think a family-focused system is already, to some extent, well recognized – within Child Youth and Family interventions, within the family conferences that are a feature of the Justice system, and within holistic approaches in the health system. Why do we need Whanau Ora? In Parliament in mid-February, the newly minted Whanau Ora Minister Tariana Turia offerred this rationale :

Because the results for whanau have been disappointing because of the poor performance across the State sector. There have been inconsistencies, fragmentation, overlaps in service delivery, duplication of effort, and, frequently, confusion and frustration for those who have sought assistance.

No doubt. The challenge will be to devise and impose this new layer of bureaucracy – one that will assess both individual need and measure collective outcomes – without adding to the existing overlap and confusion. On the basis of little more than noble aspirations, Whanau Ora purports to create a different system for managing social services in this country – one that will be funded by taking money out of the existing, badly-stretched social service departments. The consultation carried out in conjunction with this transformation consisted of a series of hui held last year that were attended, the Task Force says, by some 600 people in all nationwide, and which resulted in about 100 subsequent written submissions.

As the report says, the funds to run Whanau Ora will be derived “from relevant appropriations – including, but not limited to, Votes Health, Education, Justice and Social Development.” There is currently no information whatsoever on what existing programmes will be cut to find this money, how people will qualify for access to it, or how Whanau Ora will impact on the existing modes of delivery of social services to the wider community. Some basic questions :
.1.Will pakeha beneficiaries be managed in future via whanau principles? The Whanau Ora report portrays the new system as being entirely for Maori, and explains how it is to be managed and assessed in accord with Maori values, and with the promotion of those values. Finance Minister Bill English however, says the system will be available to all, on the basis of need.

This begs the question of the essential nature of the system. In future for instance, will a pakeha beneficiary be case-managed in terms of pakeha notions of privacy and individual entitlement, or in terms of processes and outcomes that promote the wellbeing of his or her whanau – whether or not such a whanau currently exists ? If a non-Maori is to receive Whanau Ora assistance, which set of cultural values will be applied? Is Bill English willing to guarantee that a pakeha teenager say, seeking contraceptive care – or an abortion – will not have her access to that information (and to any related procedures) shared with and decided by her (whanau) family?

Such concerns are not hypothetical. What Whanau Ora envisages is a shift away from a system that is based on individual entitlement, management and outcome assessment – to one where the essential unit is the whanau collective. Turia has pointed out how the fragmented, overlapping nature of the current individualized system can and does impact negatively on many Maori. True enough. Yet if funds for social services are to be taken from the current system and funneled through Whanau Ora instead – will pakeha (or Maori for that matter) still retain the freedom to opt out of it? Or in future, will decisions on access and entitlement to healthcare and welfare be decided by the family patriarch designated by Whanau Ora to liaise with the integrated health and welfare provider?

2. How are the privacy implications being addressed? New criteria for assessing need and ad new ways of measuring outcomes will be introduced. Greater “integration” of health, education and welfare delivery is being promised without any recognition of the implications for data privacy in data sharing between departments, and – more importantly – between those departments and the ‘integrated” provider. There are good privacy reasons for not pooling this kind of information. In short : what has Privacy Commissioner Marie Shroff to say about the data storage and access implications of Whanau Ora?

3. To what degree will Whanau Ora contracts be treated as commercially sensitive ? Currently, much of the workings of Social Welfare and Health are open to OIA enquiry. Some issues of commercial sensitivity apply with existing contracts. The issue here is one of scale. If there is to be a wholesale privatisation of health, education and welfare delivery to these ‘integrated’ providers out in the community, how accessible and accountable to public scrutiny is the work of these providers intended to be ? Can the government guarantee that the allocation of contracts and the measurement of outcomes will be transparent, and open to OIA scrutiny ?

4. How is the success – or failure – of Whanau Ora to be judged? Turia has said that outcomes will be the crucial factor here. Yet logically, the problems that are being addressed here have been decades – even centuries – in the making. Realistically, can any measurable success be expected in the short term, and even if the relevant health and employment indices improved or worsened, could this be attributed in anything like cause and effect fashion, to Whanau Ora ? Especially given that Whanau Ora will always be operating within the framework of wider government policies?

The short answer is, no. Whanau Ora is a set of aspirations for the resolution of intergenerational problems, and policy and delivery frameworks are being made up on the hoof. Measuring progress on such deep seated social problems would be hard enough in any circumstances. To boot though, the Whanau Ora Task Force has done much to insulate the scheme from any meaningful external measurement of outcomes.

Under the principle of Whanau Integrity for instance, the Task Force “acknowledges the need for whanau accountability, whanau innovation and whanau dignity. This principle assumes that a code of responsibility is present in all whanau, though it may sometimes be masked by events or circumstances that propel whanau into survival mode or trigger a defensive reaction.” Meaning : underneath any“masking” that may be apparent, all whanau are assumed to have an inherent integrity and readiness to be accountable – unless that is, you push them into being defensive, or “propel” them into “ survival mode.” In which case, watch out.

Nor should, the Task Force reasons, whanau performance be judged by external, individual based criteria. Whanau and the providers should help to decide how their own performance is to be judged. As para 7.4.3 says, “Selecting the most appropriate outcome indicators is a task that should involve whanau, practitioners and funders.” And don’t judge them negatively: “ A whanau-centred approach must take into account the aspirations of whanau as well as provider realities and wider community and societal goals. “ Basically, let whanau decide whether outcomes have been achieved :“In an outcome-focused environment, it will be important that whanau…agree on the indicators that might be used to measure success.”

Or indeed, allow whanau to decide whether success has been achieved at all: “Whanau would also play a large part in determining the criteria for ascertaining when objectives had been achieved.” Which, as mentioned, could take a very long time to determine : “Realistically however, impacts of whanau-centred services would take time (several years and, in some cases, generations) to feed through into these types of population-level indicators. “

In short, there is nothing in the document likely to foster confidence that the Whanau Ora system has the means – or even sees the need – to assess whether their approach is succeeding, or failing. It asks that good intentions be taken on faith, and the necessary funding handed over.

5. How will the funding avoid capture? Funds can be captured at two levels : at whanau level by a dominant whanau member, or family unit within the whanau itself – or secondly by locking in the “integrated” provider. The Task Force recognizes the latter problem, at least. It cites concerns expressed at the Whanau Ora hui that funding be dispersed as close to the grass roots as possible – but also cites the opposite view, expressed by those who wanted the funding to be dispersed by a national body, to avoid capture by parochial interests :

At one hui the principle of subsidiarity was recommended – the devolution of responsibility to the smallest possible unit. Apart from a closer relationship between funders and providers, the subsidiarity principle would enable local need to be better reflected in funding decisions.

There were other views, however, that local decision- making might be subject to capture by particular factions and, as a result, some providers could be disadvantaged. In that case it was argued that there would be some advantages in having a national body sufficiently removed from parochial interests to support programmes that were most likely to deliver the desired outcomes.

Rather than explain how these issues will be addressed, the Task Force merely asserts its preference for a model run by an independent trust with ten regional panels, working with integrated providers responsive to whanau needs. If only it were that easy.

6 What is a whanau? Given that the entire system is based on the whanau, and the values that it is seen to embody, one might have expected greater clarity on what a whanau actually is. Indeed in its initial paragraphs, the Task Force points to how urban drift, emigration, industrialisation and now, globalization have all served to erode the meaning of whanau. Conversedly, the Internet, the Task Force suggests, has helped whanau to maintain contact and retain the ties with its members.

The Task Force definition is hardly a precise one: “A multi-generational collective made up of many households that are supported and strengthened by a wider network of relatives.” Where that wider support network doesn’t exist, policy will be expected to recreate it. The whanau is to be the foundation unit: “It is critical that the cultural distinctiveness of whanau is recognised in the delivery of services. Despite varying levels of participation in te ao Maori, this is a central component of contemporary whanau experience. Services should be attuned to whanau cultural norms,
whanau traditions and whanau heritage, while at the same time recognising the realities and opportunities in te ao Maori and in wider society.

Quite openly, the Whanau Ora approach is to serve as an explicit form of social engineering. Where whanau has lost relevance, or where links to iwi and hapu have broken down, the Whanau Ora policy will be expected to rebuild them. The following principles, the Task Force says, will guide the selection of indicators, outcome measures, and the allocation of funding for whanau-centred initiatives:

• nga kaupapa tuku iho (the ways in which Maori values, beliefs, obligations and responsibilities are available to guide whanau in their day-to-day lives) • whanau opportunity, best whanau outcomes, whanau integrity, coherent service delivery, effective resourcing and competent and innovative provision.

Just how this melange of good intentions will unfold, which existing services will be axed to fund it, and how it will be accessed by non-Maori all remain to be seen.